Norwegian doctor loses right to public reimbursement after 35 years

A Norwegian doctor with nearly half of his municipality’s population on his patient list has been stripped of his right to receive state reimbursements after 35 years in practice, following an audit by the Norwegian Health Economics Administration (Helfo).

According to a report by Dagbladet, Arnaldo Lerner, a general practitioner in Grue municipality, must close his practice within a month after Helfo ruled he had claimed NOK 2.5 million (approx. €220,000) more in reimbursements than entitled. The decision, finalised in March, follows an initial warning issued in December 2025.

Lerner, who serves around 2,100 patients, has previously stated that his long working hours—often from 5:30 AM to 7:30 PM—led to an efficient but disputed billing system. His lawyer, Nils Grytten, told Dagbladet that once Helfo issues a preliminary warning, the outcome is nearly always a loss of reimbursement rights.

“In about 90 percent of audited cases, doctors lose their reimbursement rights. If you’re selected for review, you’re in serious trouble,” Grytten said. He added that he knows of no case where a warning did not result in a final decision, despite Helfo’s claim that doctors can submit objections before a ruling is made.

Medical association raises concerns over “black-and-white” enforcement

The Norwegian Medical Association has criticised Helfo’s audit practices as disproportionately harsh, filing a formal complaint with the Parliamentary Ombudsman in 2025. Øyvind Anmarkrud, a lawyer and special advisor for the association, argued that while oversight of public funds is necessary, Helfo’s approach has become rigid and fails to account for professional disagreements.

“Our view is that Helfo has gone too far, revoking reimbursement rights in too many cases,” Anmarkrud said. He noted that disputes often centre on documentation requirements—such as how much must be recorded in patient notes to justify billing—where Helfo’s interpretation of “gross negligence” may clash with medical consensus.

Helfo defends its stance on its website, stating that revoking reimbursement rights is a measure to “prevent future misuse of public funds.” However, Anmarkrud countered that many doctors comply with adjustments after initial warnings, eliminating the risk of further misuse. “The penalty becomes disproportionate,” he said.

In 2025, 29 healthcare providers lost their reimbursement rights under Norway’s National Insurance Act. Once revoked, the decision can remain in effect for up to five years, effectively ending a doctor’s ability to practice under the public system.